CT图像纹理分析对小于10 mm纯磨玻璃结节侵袭性的诊断价值

doi:10.3877/cma.j.issn.1674-0785.2019.05.009

目的

探讨CT图像纹理分析对小于10 mm纯磨玻璃结节的侵袭性的诊断价值。

方法

收集2015年1月至2017年3月在无锡市人民医院行手术治疗的<10 mm纯磨玻璃结节148例，其中浸润前病变组73例，浸润性病变组75例，运用ImageJ软件对其图像进行纹理特征提取，并找出2组有差别的参数，运用Spearman相关性分析进行特征性降维，找出独立的预测因子，再运用受试者工作特征曲线评价独立预测因子的诊断效能。

结果

影像特征提取得到31个CT图像纹理特征参数，差异有统计学意义的参数有19个，经降维处理最终得到3个与肺腺癌浸润性相关的独立参数，即角二阶矩、相关性和逆差矩，曲线下面积分别为0.715、0.720、0.736。

结论

CT图像纹理分析对判断早期肺腺癌的浸润性有一定的诊断价值。

关键词: 纹理分析, 肺肿瘤, 肿瘤浸润, 体层摄影术，X线计算机

Objective

To assess the value of CT texture analysis in diagnosing the invasiveness of lung adenocarcinoma manifesting as pure ground glass nodules less than 10 mm.

Methods

The preoperative CT data of 148 patients manifesting as pure ground glass nodules less than 10 mm who underwent operation were analyzed retrospectively. Among 148 cases of pure ground glass nodules, 73 were preinvasive lesions and 75 were invasive lesions of lung adenocarcinoma. ImageJ software was used to extract the texture features of the images and then the parameters that differed significantly between the preinvasive lesions and invasive lesions were identified. Spearman correlation analysis was used for feature dimension reduction, and then independent predictors were selected out. Receiver operator characteristic curve was then used to evaluate the diagnostic efficiency of independent predictors.

Results

Among 31 parameters of texture feature obtained by CT feature extraction, 19 statistically differed between the two groups. Three independent parameters related to lung adenocarcinoma invasiveness were obtained after dimension reduction, which were angular second moment, contrast, and inverse difference moment. The areas under the curves of the three parameters for diagnosing the invasiveness of early lung adenocarcinoma were 0.715, 0.720, and 0.736, respectively.

Conclusion

CT texture analysis is helpful in the diagnosis of invasiveness of early lung adenocarcinoma.

Key words: Texture analysis, Lung neoplasms, Neoplasm invasiveness, Tomography, X-ray computed

图1 浸润前病变和浸润性病变角二阶矩、相关性和逆差矩的受试者工作特征曲线

表1 浸润前病变组和浸润性病变组有差异的特征性参数（±s）

病变	角二阶矩	相关性	逆差矩
浸润前病变	0.013±0.005	0.003±0.002	0.149±0.008
浸润性病变	0.004±0.002	0.002±0.001	0.092±0.051
双侧P值	<0.001	<0.001	<0.001

表1 浸润前病变组和浸润性病变组有差异的特征性参数（±s）

病变	角二阶矩	相关性	逆差矩
浸润前病变	0.013±0.005	0.003±0.002	0.149±0.008
浸润性病变	0.004±0.002	0.002±0.001	0.092±0.051
双侧P值	<0.001	<0.001	<0.001

表2 浸润前病变和浸润性病变曲线下面积及其95%可信区间

检验结果变量	曲线下面积	标准误^a	双侧P值^b	95%可信区间
角二阶矩	0.715	0.042	<0.001	0.633~0.797
相关性	0.72	0.042	<0.001	0.638~0.801
逆差矩	0.736	0.04	<0.001	0.657~0.815

表2 浸润前病变和浸润性病变曲线下面积及其95%可信区间

检验结果变量	曲线下面积	标准误^a	双侧P值^b	95%可信区间
角二阶矩	0.715	0.042	<0.001	0.633~0.797
相关性	0.72	0.042	<0.001	0.638~0.801
逆差矩	0.736	0.04	<0.001	0.657~0.815

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CT texture analysis in diagnosis of invasiveness of lung adenocarcinoma manifesting as pure ground glass nodules less than 10 mm

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CT texture analysis in diagnosis of invasiveness of lung adenocarcinoma manifesting as pure ground glass nodules less than 10 mm